Emotional traits, self-care and emotional regulation in young early-stage breast cancer women: an observational study on survivorship psychological adaptation

Abstract

Background: Cancer can be a chronic condition and breast cancer diagnosis may impact many aspects of life with significant reductions in emotional functioning and self-care behaviors. The aim of the study was to examines relationship among individual psychological dimensions, self-care and emotional regulation processes and investigate the mediating role of emotion regulation process for disease management in breast cancer. Methods: An observational study was conducted. Thirty-eight breast cancer patients (M 45.2±sd 7.87) participated in the study. The sample was distributed in two groups by time from diagnosis (median 14,5 months): Early and Long groups. The psychological battery was administered during clinical follow-ups: Depression Anxiety Stress Sscale-21, Difficulties in Emotion Regulation Scale-20, Self-Care of Chronic Illness Inventory. Results: Significant differences on psychological dimensions emerged by time from diagnosis. Long group experienced lower self-efficacy (p = 0.002), higher depression (p = 0.014) and lack of emotional clarity (p = 0.004). Controlling for time from diagnosis, negative correlations emerged between self-efficacy and depression (p = 0.020, r = -0.382), stress (p = 0.033, r = -0.351), lack of emotional clarity (p = 0.040, r = -0.339), also positive correlations emerged between emotion dysregulation and psychological distress indexes. Finally, mediation analysis showed the significant effect of lack of emotional clarity on self-efficacy (β=-0.192; SE=1.304; p0.021; CI=-5.56– -0.45). Conclusions: This evidence suggests that the relationship between time from diagnosis and self-efficacy is mediated by emotional dysregulation. Emotional regulation process seems to be a mediating factor in the management of breast cancer in long time. Limitations of the study include a small sample size, residual confounding variables, the lack of longitudinal data. Our findings highlighted that young breast cancer patients were emotionally challenged by ongoing clinical path and underscored the need in clinical practice to provide psychological screening of emotional regulation process in order to implement tailored psychological support to improve health outcomes and enhance women's well-being in survivorship. In clinical setting, the integrated approach could realistically allow early detection and treatment of psychological factors such as emotional dysregulation that could negatively interfere with long-term disease management impacting self-care abilities.

Keywords

• breast cancer
• clinical psychology
• chronic illness
• emotion regulation
• self-care.